Tag Archives: health care

Dangerous Mistake

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The Trump administration is completing its move to change the classification of marijuana from a Schedule I drug…alongside LSD and heroin…to Schedule III, making it obtainable with a prescription.

This is a mistake on two fronts. The first is that marijuana is a highly dangerous drug, having been bred explicitly to strengthen its effects. Those effects include brain damage on developing brains, and human brains are always developing; although the pace of development slows markedly in a human’s middle twenties. The damage done, too, isn’t like a smoker’s damage to his lungs, which can be mostly repaired if the smoker stops smoking. Despite the plasticity of our brains, damage done chemically by the materials in marijuana is permanent.

That leaves aside the slowed reflexes and impaired judgment of a marijuana user while he’s using. Driving or operating machinery while under the influence of marijuana is just as dangerous to the user and to others as is driving or operating machinery while drinking alcohol.

The other front is that this is the wrong place to make money. The profits from universally legal cultivation and sale of marijuana qua marijuana is just chump change compared with the profits available from commercializing marijuana for medicinal use. There is a plethora of anecdotal evidence that marijuana helps with pain management, PTSD, depression, and the like. That warrants serious research to determine the specific chemicals and chemical combinations in marijuana that have these and potentially other medicinal benefits.

With that successful research, and I submit that with concerted effort by a variety of pharmaceutical companies, success is within five years, the cultivation of marijuana for medicinal purposes and the extraction of those chemicals and chemical combinations can be done under license (which we already know how to do in the narcotic medicine venue). Those actual medicines then can be sold under prescription or over the counter, depending on the specific combination. (I’m eliding here the fact that herbal medicine—which is what marijuana would be, even by prescription—suffers badly from inconsistent dose control.)

Republicans and Health Care

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Republican Congressman Jen Kiggans (VA) laid out the problem and in the process exposed an all too typical Republican timidity:

We run on this every time, there’s not an election that comes up where we don’t get beat up on healthcare[.]

Republicans far too routinely cower away from directly addressing healthcare, identifying who’s responsible for the problem, or what to do about it.

Some party elders now say Republicans’ best strategy might now be to avoid the issue altogether.

They’ve had this hide-under-their-desks posture ever since their one serious attempt at health care coverage reform went down in flames via ex-Senator John McCain’s late night showboating No vote killing a bill that would have rescinded Obamacare and restored the then-status quo ante.

A few days ago, Republicans in the Senate (which the press routinely and dishonestly characterizes as “Republican controlled”) offered a bill that would have redirected expiring Affordable Care Act subsidies to individual taxpayers’ Health Savings Accounts, which the bill also expanded explicitly to accommodate those payments. The bill failed on a cloture vote as the minority Progressive-Democratic Party’s Senators bloc-voted against it (thereby demonstrating that a majority of Senators does not confer on that majority party “Senate control”).

Asides aside, what’s shamefully cowardly is that, both during the Republican proposal’s runup to the vote and since the vote, all of those Republicans have been silent on one Critical Item: the Progressive-Democrats’ constant demand for subsidies for the ACA proves how unaffordable is their health care coverage program and how desperately that program needs reform. True, a few Republicans mentioned that the Progressive-Democrats had designed their subsidies to expire at the end of this month, but those were just occasional afterthoughts in other conversations.

It would be good for Republicans, and it would be good for our nation, if Republicans individually and as a political party—including at the State level as well as national—would but screw their courage to the sticking place, and they’ll not fail—not at health care reform, not at getting elected and reelected, and not at maintaining their majorities.

It’s clear that Obamacare/ACA is an utter failure at making health care coverage affordable—even with those taxpayer-funded subsidies, too many premiums in the government’s health coverage market are sky high, and deductibles and the out-of-pocket costs (even capped) are significant fractions of the incomes that the government defines as poverty-level. It’s also clear that Medicaid is rife with fraud and abuse (and waste, but the other two are the most rampant).

Republicans need to talk about health care loudly, frequently, and in specific terms, naming both the outlandish health coverage expenses and the politician they’re campaigning against who favors those expenses and favors keeping Americans dependent on any government they run. Republicans also need to explain in clear, no uncertain terms, that the cuts to Medicaid and the rules for eligibility that they passed in the One Big Beautiful Bill Act actually make things better for legitimate Medicaid recipients. Those reforms cut out those ineligible, like illegal aliens in sanctuary States; add income caps to eligibility; and require the able-bodied to work, actively seek work, train for work, or volunteer. Those reforms make more money available for those truly needing Medicaid.

In parallel, Republicans need to push a specific, concrete health coverage reform package that drastically modifies ACA or outright replaces it. This one requires the Chaos Caucus and the entrenched leadership to get off each other’s throats and coalesce around a specific, concrete package.

Republicans have wasted enough time bickering among each other under their collective House/Senate desk.

If They Depend on Subsidies…

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…then they shouldn’t be in business. The subheadline laid it out:

Republicans want to shift subsidies away from some of the frailest companies in the industry

In this context, “the industry” is the health care coverage industry, and the subsidies are those paid health coverage providers in the Affordable Care Act. I claim, though, that “private” companies that require government handouts are neither all that private nor deserving of staying in business. If they cannot survive without taxpayer money as anything more than a shortish-term loan to survive a catastrophe, they should be left to go out of business.

The news writer at the link made a big deal out of the need for the subsidies to those coverage providers in order to hold down the prices—the premiums—the customers pay for the policies, jerking tears especially for the lower income customers. What he does not address, though, is the deductibles and the out-of-pocket caps those Obamacare policies have. The deductibles and caps each separately represent significant fractions of those lower income customers’ income. They, especially, had better not get sick. If they do, their strait is not much different from that of those folks who are uninsured at all.

The subsidies paid into their hands directly would at least give them a little relief, but that’s only a stop gap. The real solution is to eliminate the ACA altogether and free up the health care coverage industry, restoring it to a health insurance industry in a free market with policies marketable nationwide, rather than limiting them to intrastate sales with the permissions and regulations of fifty different States.

Companies providing health care coverage or insurance should see their prosperity in how well they treat their customers and how well they serve them. Their prosperity should not come from government handouts—transfers from us taxpayers who don’t use their services.

The Problem with Obamacare Subsidies

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Tony LoSasso, DePaul University Professor of Economics, and Kosali Simon, Indiana University Distinguished Professor of Economics, think the problem with Obamacare subsidies is their structure and not their size, and they want a shift to a Centrally Planned scheme akin to the government-approved form of competition that is the Federal Employees Health Benefits Program, wherein Government decides (still) what is a suitable subsidy and peg[s it] to a lower-cost, benchmark plan. Under this, the coverage who selects a higher-cost plan must pay the cost increment himself. That this is all too similar to Obamacare and its Bronze plan subsidization, with consumers choosing pricier options paying the difference isn’t particularly relevant here.

LoSasso and Simon are missing the beam in one eye for the mote in the other. The problem with Obamacare subsidies isn’t their size, nor is it to whom they should be sent, as some on the right are starting to propose.

The problem with Obamacare subsidies is their existence. This broad government coverage scheme of Obamacare, advertised—still!—as the Affordable Care Act, is not, never has been, and never was intended to be affordable. The Act was intended from the outset to nationalize our nation’s health care coverage industry.

The only real solution, the only one with long-term durability, is to move our health care coverage industry back to its actual health insurance roots, and then to go a few steps further. Make insurance plans entirely salable across State boundaries. What began that century or more ago in a nascent health provision and health insurance process as wholly local and completely intrastate has long since grown to nation-wide production and market facilities, and that’s readily regulable under our Constitution’s Commerce Clause. Make health insurance policies available in one State available to prospective insurees in all States. That alone will let policy costs to the insuree (premiums, co-pays/out-of-pocket caps, deductibles) go down since the insurer will have only one set of rules with which to comply rather than 51 (the States plus the Feds).

In addition, it’s necessary to take the shackles off what insurers (not government coverage purveyors) are allowed to sell and what customers, insurees, are allowed to buy. These salable policies would range, under true, unfettered by Government, competition, from the full-up policies of pre-Obamacare that covered a broad range of ails and potential ails to policies that would cover only specific or closely related ails and potential ails to everything in between, including the sale and purchase of customer-selected bundles of policies covering specific closely related ails and potential ails.

A freely competitive market with far more limited government involvement is what will drive health insurance costs down and policy quality up. And that will have an important sequela: doctor availability, even for those on the bottom economic rungs, will go up.

All of that will take taxpayers out of the business of paying for coverages that don’t apply to them, especially including those taxpayers who otherwise would eschew health insurance altogether.

That, too

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Progressive-Democrats are keeping the government shut down over their demand to extend—permanently, no negotiations—the Obamacare subsidies that the Progressive-Democrats during the Biden reign had scheduled to expire in November of this year, pretending at the time that the subsidies were just temporary, to tide people over during the Wuhan Virus situation. Their core claim on this aspect is that Obamacare premiums, as paid by the policy holder (carefully excluding, per those same Progressive-Democrats, the premium costs paid for by us taxpayers via those subsidies), will explode.

What the press, with equal care, ignores is that the purported need for those subsidies is a direct result of the cost of the government-run health care coverage program that is the Affordable Care Act. Government-run because these are coverage policies whose coverage suites are mandated by government, including the worst mandate of them all: the requirement to charge premiums (within narrow government set bands) for ailments and potential ailments without regard for the risk of the ailment being covered, and for some of those ailments at no cost to the policy holder at all.

The Wall Street Journal has pointed out an additional price to us average Americans:

If Republicans don’t extend the turbocharged subsidies, she [Minnesota Progressive-Democrat Senator Amy Klobuchar] warned, “early retirees like Bill & Shelly [who live in Meridian, ID] will see their health insurance premiums increase nearly 300%—from $442 to $1,700.”

And [emphasis added]

This is a tacit admission that ObamaCare encourages Americans to stop working. The Biden subsidies turbocharged that incentive by making subsidies larger and available even to those with incomes above 400% of the poverty line. The couple in Ms Klobuchar’s example had north of $130,000 of income in 2024….

This demand for permanentizing the ObamaCare subsidies is just one more aspect of big government taking over our lives, reducing individual liberties (the health coverage industry does not exist in a free, competitive market where individuals can make their own choices of what coverages they want, at prices that competition would make possible) and taking the flip side of individual liberties, individual responsibilities, away from the individual and, instead, spreading them across all of us together, as brokered by Government.

The editors offer some solutions that would be a good beginning toward correcting the failure that is the ObamaCare essay into socialized medicine.

  • codifying association health plans that let small businesses join up to form a larger risk pool to improve the economics of offering insurance
  • continuing to expand plans that can be paired with tax-preferred health-savings accounts
  • fix[ing] some ObamaCare regulations like the medical-loss ratio that obliges insurers to spend 80% of premiums on claims, which in practice is a profit cap

Also needed, I claim:

  • allowing health coverage plan providers to sell policies that cover preexisting conditions at premiums consistent with the risk involved. The risk here is not certainty since the preexisting conditions will not all flare up and require medical intervention simultaneously; the risks can be amortized across time, if government only got out of the way
  • allowing individuals to choose from, and insurers to offer, tailored coverages: only primary care—annual exams, for instance, and the occasional flu or broken bone
  • coverages only for catastrophic health potentialities
  • reducing the regulatory burden on doctors who want to eschew being reimbursed via health coverage providers by doing cash reimbursements, perhaps by annual subscriptions

But to do any of that, it’s necessary for the Progressive-Democrats to end their extortionate demand on subsidies as a condition or reopening, so those discussions can begin; it’s necessary for the Progressive-Democrats to release from their basements us American people, especially the poor and their children, whom they’ve taken hostage against their demand.